CPAP Equipment Cleaning and Replacement

For people with sleep apnea and for their healthcare professionals, peer coaching article #21, updated 3 December 2011

Practices vary among users. It usually works to clean less often than the manufacturer recommends. In order to prolong equipment life, keep the dry mask, headgear, and hose out of direct sunlight. To make your bedroom look less like a hospital, cover the hose with a hose cover and consider covering the dry mask with a scarf, piece of decorative fabric, extra pillowcase or towel, or place it in a drawer or under the bed linens. Hose covers and hose connectors are sold on cpap.com . When you get a new mask or hose, experiment with reducing the odor by soaking it in soap and water, then soaking it in a vinegar solution, rinsing it in a baking soda solution, and then rinsing and air drying.

Masks
First remove the mask from the headgear to keep the headgear dry. There is usually no need to take apart the mask because it’s unnecessary for routine cleaning, reassembly might be difficult, and the mask parts might start leaking after reassembly. Many users find that only completely washing the mask each morning will remove facial oils and improve the fit the next night. (Go to bed with a clean face and do not use facial moisturizers at night.) To clean the mask, use a large clean bowl or container to immerse the mask or nasal pillows in warm tap water with a detergent without fragrances, moisturizers, conditioners, or grease cutters, such as Johnson’s baby shampoo or Seventh Generation dishwashing liquid. Equally effective but less foamy is mild, unscented soap without anti-bacterial agents or moisturizers, such as pure castile soap, Dr. Bronner’s unscented liquid castile soap, Ivory bar soap, or Neutrogena liquid soap. Avoid rubbing the delicate silicone. Soak briefly, swish, rinse well, and air dry. Dry the mask out of direct sunlight to avoid sun damage over time. Commercial respiratory equipment cleaners are also available online. Have a workable spare mask and headgear in case your mask breaks, is still wet if you want to nap, and for travel.

If you can’t or don’t want to immerse your mask daily, minimally, use soapy water on a cotton ball daily to remove facial oils from the part of the mask that touches the skin, rinse those portions, and air dry. Other options, especially useful when traveling, are Citrus II CPAP Mask Wipes, benzalkonium chloride towelettes, or alcohol swabs. Avoid using towelettes or wipes with fragrances and moisturizers that will damage the silicone, contribute to mask leaks, or irritate the skin over time.

For ideas on specific detergent brands see http://www.cpaptalk.com/viewtopic.php?t=12724 and for frequency of cleaning, see http://www.cpaptalk.com/viewtopic.php?t=12480 and http://www.cpaptalk.com/viewtopic.php?t=11445&highlight=cleaning+birdshell

Headgear. If hair is shampooed daily or frequently, headgear doesn’t need to be cleaned often. When headgear needs cleaning, it can be hand washed in mild soapy water, rinsed, and air dried. If your headgear stretches over time, tighten the fit or get new headgear.

Hose. Disconnect the hose on both ends every morning and let it air dry, leaving it in the hose clip or ponytail Scrunci holder attached to the headboard, wall, or ceiling. If there is high humidity and the hose doesn’t air dry, consider alternating between two hoses. Wash the hose weekly, every other week, or after infections. rinse, air dry. Pour soapy water into the hose, use a hose-to-hose connector to attach both ends and make a loop, or cover the ends with your hand, swish, rinse, and air dry. People with heated hoses usually don’t clean them. After an infection, the heated hose could be cleaned by holding both ends, pouring soapy water into the hose, swishing, and rinsing. Avoid wetting the cloth cover on the outside of the heated hose since the electrical wiring is under it on the outside of the heated hose. Check for hose leaks occasionally, especially if you have a cat with claws, by running your hands over the hose with the machine turned on. Have a spare hose in case your hose gets damaged and for travel. When you get a new hose, experiment with reducing the odor by washing it in soap and water, then soaking it in a vinegar solution, rinsing it in a baking soda solution, and then rinsing and air drying.

Humidifier. To save distilled water, watch how much distilled water you use overnight at your humidity setting and fill it only to that level. Don’t go over the fill line or the CPAP may not work properly. For convenience, keep the distilled water in your bedroom. Distilled water is inexpensive and it’s better to waste a little than to develop an unsanitary humidifier. Bacteria and molds won’t grow on a clean, dry surface. Empty and open the humidifier daily to let it air dry. Some models need careful prying apart with your fingers or a dull butter knife. If you need to keep water in it for a day or two in order to take a nap, that’s okay. Immerse the opened humidifier every couple of weeks in soapy water, rinse well, air dry. There is no need to take apart the baffle unless you start to grow microscopic critters, mold, mildew, and algae, which could be damaging to your lungs. Wash the humidifier weekly if you don’t empty and air dry it daily. Avoid using tap water in the humidifier because of added chloride and mineral build-up in the tank. If you are forced to use tap water and get a mineral build-up, it may be unsightly but not harmful. Try removing it with a vinegar solution. Don’t use harsh chemicals that may leave a residue and be harmful to inhale. If you are traveling and don’t carry or buy distilled water, use bottled water in a pinch.

Other options that may work: some people empty and air dry the water daily but rarely wash the humidifier. Some don’t empty the tank, just top it off with distilled water each night, and rarely wash the humidifier. However, not emptying the humidifier daily may contribute to build-up of mold and mildew inside the machine. If you choose not to empty the water, at least remove the humidifier from the machine so the inside of the machine can dry out daily. You may be using that machine for five years or more, so avoid building up mildew and dust inside the machine, since what’s inside the machine blows into your lungs. If the humidifier leaks, to avoid damaging furniture, place something like a rimmed cookie sheet or inverted plastic box lid under your machine and humidifier. A long and rambling discussion thread on emptying humidifiers: http://www.cpaptalk.com/viewtopic.php?t=5075&postdays=0&postorder=asc&start=0

Vinegar solution. If you have an infection, another cleaning solution for your mask, hose, and humidifier, not necessarily better than soapy water, is 1 part white household vinegar to 4 parts water, or 10 parts water. Soak for about 15 minutes and thoroughly rinse. To eliminate the lingering smell of vinegar, give the equipment a short soak in water with baking soda added and rinse in tap water and air dry. Or use a commercial respiratory equipment disinfectant.

Machine filters. If your machine has one, rinse the coarser dark gray filter in tap water and air dry weekly or oftener during allergy season if allergic to pollens or pets, or every couple of weeks if not allergic. Use an alternate gray filter if the first one is still wet from rinsing. Replace when worn; it will last for many months. The fine white filter can’t be rinsed. Replace the fine white filter monthly (or more often) in allergy season or every three months (or more often) if you’re not allergic and the bedroom isn’t dusty. Mark a calendar with dates to change the white filter. Keep a few extra coarse and fine filters. Keep the machine dusted, and the area where it sits, especially near the air intake. That air blows directly into your lungs. Some people change their filters after using their machine in hotel rooms or camping. Avoid getting campfire smoke in your machine since it may smell of campfires forever after. (Use an old machine or consider getting a second, smaller and lighter machine with battery backup for power outages, travel and camping.) Remember to change your furnace and air conditioner filters, too, and consider a hepa filter air purifier in the bedroom or home.

Equipment replacement. Medicare establishes CPAP equipment replacement guidelines for Medicare participants. Insurance companies start with those guidelines but make their own decisions for a replacement schedule. Ask your insurance company for the replacement schedule that applies to you. Since new hoses offgas an odor, you may decide to not replace your hose as often as allowed, but have a spare in case of damage. When you get a new mask, filter, or hose, write down the delivery date and mark your calendar with a replacement date reminder.

Discussion thread on machine repair: http://www.cpaptalk.com/viewtopic/t13699/Servicerepairs-to-Respironics-xPAPs-and-online-buying.html

“What Every CPAPer Needs to Know,” many helpful hints in this link:

http://www.cpaptalk.com/viewtopic/t14746/Please-Share-Misc-Helpful-Hints.html

Accessory Wish List
http://www.cpaptalk.com/viewtopic.php?p=127510#127510

Leaving machine plugged in
http://www.cpaptalk.com/viewtopic/t14929/Leaving-the-Apap-plugged-in.html

Sources: Based on personal experience with obstructive sleep apnea and gleaned from the collective wisdom of cpaptalk.com contributors.

Want more? See the peer coaching articles at http://smart-sleep-apnea.blogspot.com , http://www.cpap.com FAQ Learning Center, or search http://www.cpaptalk.com or post a message there.

Not written by healthcare professionals. The information and opinions offered are not intended or recommended as a substitute for professional medical advice.

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